Fever, hospitalization and healthcare utilization after research bronchoscopy

Abstract

Background and aims: Based on a study on airways inflammation and the respiratory microbiome, we aimed to investigate if bronchoscopy leads to fever, healthcare utilization or hospitalization in obstructive lung disease and control subjects.

Methods: From the ongoing Bergen Airways Microbiome Study 39 COPD patients (FEV₁ ≥ 17% of predicted values), 2 with asthma, and 33 controls were interviewed 1 week after bronchoscopy regarding fever and healthcare utilization (hospitalization, unscheduled visits to a doctor, antibiotic use). Bronchoscopy included collected protected specimen brushes in both lungs, and bronchoalveolar lavage (BAL) of the right middle lobe in all but 7 subjects. 50 subjects received conscious sedation with alfentanil. 24 subjects received only topical lidocaine.

Results: 31 women and 43 men, aged 35 to 81 years were examined. The post bronchoscopy fever rate was 41%, and was not related to healthcare utilization. 7 subjects received unscheduled medical care after the procedure, of these 1 was admitted for a bronchospasm (1 day), 2 for pneumonia (1 and 2 days), and one for 3 days for an unverified cerebral vascular incident. Case/control-status, sex, age, smoke, FEV₁% of predicted, arterial PaO₂, BAL yield, and conscious sedation were not associated with fever or healthcare utilization. A combination of low FEV₁, exacerbation history and high symptom score did not predict outcomes in a logistic regression model.

Conclusion: Fever was a frequently reported side effect of bronchoscopy, but was not related to need of healthcare attention. Neither case/control status nor FEV₁ was related to healthcare utilization. Research bronchoscopy is safe in COPD, even with very low lung function.